Friday, September 16, 2011

20 Week Ultrasound Results

We are having a baby girl! A mother always knows. Lydia Rae, weighs approximately 11 ounces, and has all the appropriate body parts. Apparently, she looks great! Our estimated due date remains January 31st. Her heartbeat is still strong, the heart anatomy looks solid, her brain looks good (the doctor said he predicts an IQ of 215), everything looks as it should. Also, my first and second trimester integrated prenatal screening results have come back and are within normal limits (Lydia is low risk for down syndrome and a few other conditions). She was in the breech position on the ultrasound, but of course this does not matter in the slightest right now – fetuses are continually changing positions at this stage of pregnancy. She was sucking her hand and appeared to be sleeping for most of the ultrasound. She looks adorable. We’ll post some pictures when I get James to scan them. (I’m sick with food poisoning at the moment and can’t move from the couch.) Dorian, who has been saying he wants a sister all along, of course said, "But I want a brother" when the ultrasound tech said it was a girl. Kids, eh? I think he's happy about it now and has been making reference to her by name.

We did have a little scare during our appointment though. The ultrasound technician performed the approximately 20 minute ultrasound, taking all the measurements, clicking away on her computer, making comments like “That looks good,” “Perfect,” etc, etc, etc. When she finished, she told us she would go print us some pictures to take home and then we could go. She never returned. We were waiting approximately 15 minutes when a doctor (whom I recognize from the hospital I work at) came in. He said he had reviewed the images from another computer and that he just needed to check a few things. James and I exchanged a look and started to worry. He basically went through all the anatomy again and delved further into the heart and brain, which was actually pretty cool to see. He talked about this valve and that valve and the blood flow, and it was awesome (he also knew I was a postpartum nurse at his hospital so I think he went into more detail for my benefit). He confirmed it is definitely a baby girl and pointed out her female anatomy (and not just the lack of a penis, which sometimes results in parents finding out their supposed baby girl is actually a boy when the baby is born). Then, at the very end, he proceeded to tell me I had a low-lying placenta. Of course, my immediate thought was, “Oh no, I have placenta previa!” (For those of you who need a refresher, the placenta is an organ that connects the fetus - via the umbilical cord- to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. Placenta previa is when the placenta covers the cervix, which is the opening of the uterus - where the baby eventually needs to exit.) He assured me my placenta is not currently covering any part of the cervix. It is approximately 1.5 centimeters from the cervix, and they like it to be at least 2cm away. Usually the placenta implants on the upper part of the uterus, where the nutrient supply is the most dense. It's possible I have scarring in my uterus from the D&C procedure I had after my miscarriage, hence, the lower-uterine attachment instead. But who knows? Sometimes, these things just happen. I don't have any of the other risk factors for placenta previa. He told me, at this point, I do not have an increased risk of preterm birth and do not have to modify any of my activity. I do have to go in for a follow-up ultrasound in 6 weeks. If the placenta is still low-lying (or worse, covering the cervix), then at that point, they will continue to monitor me via ultrasound every couple weeks and possibly restrict my activity a bit. He told me that 9 times out of 10, a low-lying placenta resolves on its own and tends to move upward in the uterus as the uterus grows. He said my placenta looked nice and big, and the cord to the baby looked how it should, so he wasn’t too concerned. I have a few friends who told me they too, had a low-lying placenta at their 20 week ultrasound, and the issue resolved itself later for them.

The doctor told me if the issue does not resolve itself (even if it just remains low-lying, and does not develop into placenta previa), I will most likely have to have a c-section at the end, something I obviously don’t want but of course, would accept in this case. There is no way I would risk Lydia’s life or my life for the sake of having a vaginal birth. A c-section would not be a huge deal. It would be a huge deal if this developed into placenta previa, however, because then you are at risk for heavy bleeding and preterm birth and usually have to restrict your activity (and I have a very active job and am hoping to work up until I go into labor). Sometimes, you even have to go on bedrest or be admitted to an antepartum unit. However, as the doctor said, chances are less than 10% in my case, and I am just taking this as yet another experience I can use to learn more about prenatal health and conditions and become a better nurse! If anyone else would care to share their experiences with a low-lying placenta or placenta previa, I’d love to hear about them. Thanks!

Tuesday, September 6, 2011

Halfway

Well, this pregnancy is certainly a challenging one. I'm obviously not on bed rest, or throwing up all the time, or diabetic, or anything that would make it be officially classified as high-risk...but it's in a completely different league to my pregnancy with Dorian. I am just so tired all the time, even now after I have slept and relaxed for 5 days (the boys were away at a music festival). And I just can't sleep. Between my massive bump and waking up to pee every hour and at every little noise and having my back pain return with a vengeance and the occasional headaches and bouts of nausea (in the second trimester?!!!), I'm not the happy, glowing pregnant lady I had hoped to be again. I mean, don't get me wrong, I'm happy enough, of course, but I just don't feel entirely well, you know what I mean? I think James is probably relieved because my pregnancy with Dorian was SO easy that I talked of becoming a surrogate mother someday...I absolutely adored being pregnant! Not so much now. Still, it's a good thing. I take every experience I can and try to file it away permanently in my brain so I can empathize with my patients even more. If there is one thing I absolutely love, it's being able to relate to my patients and feel like I'm the best possible nurse I can be...well, this pregnancy is surely helping me in that regard.

I am 19 weeks pregnant now and we have our 20 week ultrasound on Wednesday, September 14th. We can't wait to check out baby's anatomy...or more importantly (as my mom keeps reminding me), the sex. It seems to be this is all anyone is interested in these days. "Do you know the sex? When do you find out the sex? Is it a girl or a boy? What do you think it is?" We get hit with all these questions before anyone asks me how I feel, or how Dorian is reacting to the pregnancy, or anything else. It's all about the sex. I guess that's true in most aspects of life. Oh wait, that's the other sex. ;) I feel the same, to be honest. I just want to know what the baby's name is (we have a girl name picked out but no boy name yet), what to tell Dorian, etc. It's going to be easier and seem more real when we can stop calling the baby "it" and start calling it "her." (I'm still 99% convinced it's a girl.) I know SO many people who are pregnant right now and we are all due within 6 weeks of each other and so far, it's all girls. When Dorian was born, it was all boys. My new moms' group was all baby boys. Our Gymboree play group was all baby boys. I do believe this to be a real phenomenon and not just some crazy coincidence...although I have no idea why, and James will totally be rolling his eyes when he reads this.

Dorian asks about the baby all the time and he'll say things like "Does the baby like that sandwich, mama?" or "The baby is making me go pee pee!" (because I always say this). He talks, often, about how he is going to feed the baby and how he wants the baby to sleep in the bottom bunk bed in his room. He asks constant questions about the baby, and has started talking to the baby. He definitely seems to have made a connection already...and that alone makes all this "suffering" worth it!